Unusual presentation of acute compartment syndrome of the forearm and hand

Abstract

A 49-year-old man was referred to orthopaedics with an acute onset of left forearm and hand swelling, widespread blisters and erythema after lying face down on the floor for an unknown period of time. He also presented with left wrist stiffness due to pain and clawing of the fingers and glove-type loss of sensation in the whole hand. Any attempt to straighten the fingers or extend the wrist exacerbated the pain. Symptoms deteriorated rapidly. Compartment syndrome was diagnosed and surgical fasciotomies of his left forearm and left hand were performed following multidisciplinary urgent discussions between plastic surgeons, microbiologists, anaesthetists and orthopaedic surgeons. The left forearm and left hand underwent extensive decompression and subsequent skin grafting and had good healing despite the initial skin presentation. The patient has made a satisfactory recovery and has required extensive hand physiotherapy and social care.